Expert opinion on the management of respiratory tract infections in outpatient settings with a focus on amoxicillin/clavulanate and cefuroxime/clavulanic acid

Abstract

Objective: To gather clinicians' perspectives on the management of respiratory tract infections (RTIs), particularly with amoxicillin/clavulanate and cefuroxime/clavulanic acid in outpatient (OPD) settings in India. Methods: This cross-sectional study was conducted among clinicians across India and included 22 questions on RTI management, focusing on antibiotic prescribing patterns, preferred therapies, treatment duration, and the use of amoxicillin/clavulanate and cefuroxime/clavulanic acid. Descriptive statistics were used to analyze the data, with categorical variables presented as percentages and visualized using pie and bar charts in Excel. Result: Out of 1,256 study participants, nearly 68% of clinicians identified RTIs as the most common infections requiring antibiotic treatment in OPD settings. Approximately 52% of participants reported that 11-20% of upper respiratory tract infection (URTI) patients had pharyngitis, and 54% indicated that 11-20% had sinusitis. Most clinicians preferred amoxicillin-clavulanate as the first-line treatment for acute bacterial rhinosinusitis, with 56% also frequently prescribing it for skin and soft tissue infections. Around 60% of the experts highlighted the broad-spectrum activity and good efficacy of amoxicillin/clavulanate. About 51% of the participants stated diagnosing pneumonia in 11-20% of patients, with 58% prescribing cefuroxime for seven days for LRTIs. Conclusion: RTIs are the most common infections requiring antibiotic treatment in OPD settings, with amoxicillin-clavulanate being the preferred first-line therapy for acute bacterial rhinosinusitis and skin infections. Cefuroxime is commonly prescribed for lower RTIs, with most clinicians opting for a seven-day treatment duration.